NM1

Insured Name

Pos: 030	Max: 1
Detail - Optional
Loop: 2100	Elements: 8

Ref

Id

Element Name

Req

Type

Min/Max

Usage

NM101

98

Entity Identifier Code
Description: Code identifying an organizational entity, a physical location, property or an individual

M

ID

2/3

Required

Code

Name

IL

Insured or Subscriber

NM102

1065

Entity Type Qualifier
Description: Code qualifying the type of entity

M

ID

1/1

Required

Code

Name

1

Person

2

Non-Person Entity

NM103

1035

Name Last or Organization Name
Description: Individual last name or organizational name
Industry: Subscriber Last Name

O

AN

1/35

Situational

NM104

1036

Name First
Description: Individual first name
Industry: Subscriber First Name
Required when the subscriber is a person (NM102=1).

O

AN

1/25

Situational

NM105

1037

Name Middle
Description: Individual middle name or initial
Industry: Subscriber Middle Name
If this data element is used and contains only one character, it is assumed to represent the middle initial.
The Middle name or initial is required when the individual has a middle name or initial.
Required if the subscriber is a person (NM102=1) and the information is known.

O

AN

1/25

Situational

NM107

1039

Name Suffix
Description: Suffix to individual name
Industry: Subscriber Name Suffix
The Suffix should be reported whenever this information is necessary for identification of the individual, for instance when a Junior and Senior are covered under the same subscriber.
Required if the subscriber is a person (NM102=1) and the information is known.

O

AN

1/10

Not recommended

NM108

66

Identification Code Qualifier
Description: Code designating the system/method of code structure used for Identification Code (67)

C

ID

1/2

Required

Code

Name

34

Social Security Number

HN

Health Insurance Claim (HIC) Number

MI

Member Identification Number

Use this number for the payer’s ID number for the insured.

NM109

67

Identification Code
Description: Code identifying a party or other code
Industry: Subscriber Identifier

C

AN

2/80

Required

1.

P0809 - If either NM108,NM109 is present, then all are required

2.

C1110 - If NM111 is present, then all of NM110 are required

1.

NM102 qualifies NM103.

1.

NM110 and NM111 further define the type of entity in NM101.

Notes:

1. Use this NM1 segment to identify the insured or subscriber whenever the insured or subscriber is different from the patient. Any necessary identification number should be provided in NM109.
2. In the case of Medicare and Medicaid, the insured patient is always the subscriber and this segment should not be used.

Example:

NM1*IL*1*SHEPARD*JESSICA****HN*999887777A~